LPC Individual Counseling Theories and Techniques 2 — Questions and Answers
Question 1: Existential therapy emphasizes which of the following ultimate concerns as central to human experience?
- Unconscious conflicts, defense mechanisms, and object relations
- Death, freedom, existential isolation, and meaninglessness (Correct answer)
- Irrational beliefs, cognitive distortions, and negative automatic thoughts
- Reinforcement histories and conditioned behavioral patterns
Correct answer: Death, freedom, existential isolation, and meaninglessness
Irvin Yalom identified four ultimate concerns in existential therapy: death, freedom (and responsibility), existential isolation, and meaninglessness.
Irvin Yalom's existential psychotherapy addresses how clients confront the four irreducible facts of existence: (1) Death — the inevitability of mortality; (2) Freedom — the absence of external structure and the need to take responsibility; (3) Existential isolation — the unbridgeable gap between self and others; (4) Meaninglessness — the absence of inherent meaning requiring individuals to create their own. Therapeutic work involves confronting these givens rather than avoiding them.
Question 2: Dialectical Behavior Therapy (DBT), developed by Marsha Linehan, was originally designed for the treatment of:
- Schizophrenia and psychotic disorders
- Borderline personality disorder and chronic suicidality (Correct answer)
- Obsessive-compulsive disorder
- Attention-deficit/hyperactivity disorder
Correct answer: Borderline personality disorder and chronic suicidality
DBT was developed by Marsha Linehan specifically for individuals with borderline personality disorder (BPD), particularly those with chronic suicidality and self-harm.
DBT integrates cognitive-behavioral techniques with acceptance strategies drawn from Zen mindfulness practice. It addresses the core dialectic: accepting the client as they are while pushing for change. DBT includes four skills modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Comprehensive DBT includes individual therapy, skills training group, phone coaching, and therapist consultation team.
Question 3: Which of the following best describes the use of 'behavioral experiments' in Cognitive Behavioral Therapy (CBT)?
- Systematic desensitization to feared stimuli in a clinical laboratory
- Structured activities designed to test the accuracy of a client's beliefs or predictions (Correct answer)
- Reinforcement schedules applied to increase adaptive behavior
- Classical conditioning procedures to replace maladaptive responses
Correct answer: Structured activities designed to test the accuracy of a client's beliefs or predictions
Behavioral experiments in CBT are planned activities designed to test whether a client's predictions or beliefs hold up against real-world evidence.
In CBT, behavioral experiments are collaboratively designed activities where clients test their beliefs against actual experience. For example, a client who believes 'if I panic in public everyone will stare at me' might enter a crowded place and notice the actual response. These experiments provide experiential disconfirmation of dysfunctional beliefs and are often more powerful than verbal challenging alone.
Question 4: Acceptance and Commitment Therapy (ACT) targets psychological flexibility through which process?
- Identifying and challenging cognitive distortions
- Accepting internal experiences and committing to values-based action (Correct answer)
- Resolving unconscious conflicts through insight
- Extinguishing conditioned responses through exposure
Correct answer: Accepting internal experiences and committing to values-based action
ACT focuses on developing psychological flexibility — the ability to accept unwanted thoughts and feelings while committing to actions aligned with personal values.
Developed by Steven Hayes, ACT uses acceptance, mindfulness, and commitment strategies to help clients make room for difficult thoughts and feelings rather than fighting them (cognitive fusion and experiential avoidance). The six core processes are: acceptance, defusion, present-moment awareness, self as context, values clarification, and committed action. The goal is psychological flexibility rather than symptom reduction per se.
Question 5: In the Gestalt two-chair technique, the purpose is to:
- Encourage the client to take on the role of the therapist to build empathy
- Facilitate a dialogue between conflicting parts of the client's personality or unfinished relational business (Correct answer)
- Help clients practice assertive communication with their partner
- Conduct a role-play of a feared social situation
Correct answer: Facilitate a dialogue between conflicting parts of the client's personality or unfinished relational business
The two-chair technique facilitates dialogue between different parts of the self or between the client and a significant person, helping integrate polarized aspects and resolve unfinished business.
In Gestalt two-chair work, the client alternates between two chairs, giving voice to different aspects of themselves (e.g., the critical voice vs. the vulnerable self) or engaging with an unresolved relationship (e.g., an absent parent). This externalizes internal conflict, making it visible and workable. Research by Les Greenberg and others supports the two-chair technique for resolving self-criticism and unfinished business.
Question 6: Which of the following is a core assumption of rational emotive behavior therapy (REBT) regarding psychological disturbance?
- Psychological disturbance is caused primarily by environmental stressors beyond the individual's control
- Humans have a biological tendency toward irrational thinking that requires active disputation (Correct answer)
- Emotional distress is rooted in early attachment failures with primary caregivers
- Unhealthy behaviors are learned through modeling and direct reinforcement
Correct answer: Humans have a biological tendency toward irrational thinking that requires active disputation
REBT holds that humans have an innate (biological) tendency toward irrational thinking and that emotional disturbance is largely self-created through absolutistic, demanding thinking.
Ellis argued that while irrational beliefs can be learned from culture and upbringing, there is also an inherent human tendency toward demanding, absolutistic thinking. This is why REBT emphasizes ongoing practice and disputation rather than simple insight — irrational thinking tends to reassert itself. The goal is not the elimination of all negative emotion but replacing extreme, self-defeating beliefs with rational preferences.
LPC Individual Counseling Theories and Techniques 2
Existential therapy emphasizes which of the following ultimate concerns as central to human experience?